Index

COMMONWEALTH OF PENNSYLVANIA'S HEALTHCHOICES   The Commonwealth of Pennsylvania's mandatory Medicaid managed care program, called HealthChoices (HC), is the largest Medicaid (MA) program administered by the Department of Public Welfare (DPW).  It consists of three components.  The Office of Medical Assistance Programs (OMAP) administers two components:  The Physical Health Program and HealthChoices Enrollment Assistance Program.  The Office of Mental Health and Substance Abuse Services (OMHSAS) oversees the third component, the Behavioral Health Program that provides mental health and substance abuse treatment services.  The HealthChoices program has three goals that guide the Department in its implementation efforts.  These goals are as follows:   To improve access to health care services for MA recipients   To improve the quality of care available to MA recipients; and   To stabilize Pennsylvania's MA spending   Although these services are provided by separate contractors, the State requires coordination and interaction between all Physical Health and Behavioral Health Managed Care Organizations. To view a list of local HealthChoices providers, click the following link: Magellan Provider Listing (click Here) The following HealthChoices Web site is a valuable resource of information about the Pennsylvania HealthChoices Program: http://www.dpw.state.pa.us/omhsas/omhchoices.asp This site provides a more detailed description of the program and a variety of information of interest.   HealthChoices Medical Necessity Criteria available.  Please see links below:   Appendix T HealthChoices Medical Necessity Criteria      Appendix T Part A1 - Adult MH Medical Necessity Criteria          <<http://www.dpw.state.pa.us/Resources/Documents/Pdf/BhPsr/PSRCoAppdxTA1.pdf>>      Appendix T Part A2 - Adult MH Service Necessity Criteria          <<http://www.dpw.state.pa.us/Resources/Documents/Pdf/BhPsr/PSRCoAppdxTA2.pdf>>      Appendix T Part B1 - Child MH Medical Necessity Criteria          <<http://www.dpw.state.pa.us/Resources/Documents/Pdf/BhPsr/PSRCoAppdxTB1.pdf>>      Appendix T Part B2 - Child BH Medical Necessity Criteria - EPSDT          <<http://www.dpw.state.pa.us/Resources/Documents/Pdf/BhPsr/PSRCoAppdxTB2.pdf>>      Appendix T Part B3 - Child BH Medical Necessity Criteria - MHSP          <<http://www.dpw.state.pa.us/Resources/Documents/Pdf/BhPsr/PSRCoAppdxTB3.pdf>>      Appendix T Part B4 - Child MH Service Necessity Criteria          <<http://www.dpw.state.pa.us/Resources/Documents/Pdf/BhPsr/PSRCoAppdxTB4.pdf>>      Appendix T Part C - Adult Client Placement Criteria          <<http://www.dpw.state.pa.us/Resources/Documents/Pdf/BhPsr/PSRCoAppdxTC.pdf>>      Appendix T Part D - Adolescent Placement Criteria          <<http://www.dpw.state.pa.us/Resources/Documents/Pdf/BhPsr/PSRCoAppdxTD.pdf>>